A simplified strategy for donor-recipient size-matching in lung transplant for interstitial lung disease
Donor-recipient size-matching has been repeatedly reported to improve outcomes following lung transplantation (LTx). However, there is significant variability in practice and the optimal strategy for size-matching is yet to be defined. For recipients with ILD, size-matching decisions are complicated...
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| Veröffentlicht in: | The Journal of heart and lung transplantation 2021-11, Vol.40 (11), p.1422-1430 |
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| container_title | The Journal of heart and lung transplantation |
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| creator | Riddell, Peter Ma, Jin Dunne, Ben Binnie, Matthew Cypel, Marcello Donahoe, Laura de Perrot, Marc Pierre, Andrew Waddell, Tom K. Yeung, Jonathan Yasufuku, Kazuhiro Tomlinson, George Singer, Lianne G. Keshavjee, Shaf |
| description | Donor-recipient size-matching has been repeatedly reported to improve outcomes following lung transplantation (LTx). However, there is significant variability in practice and the optimal strategy for size-matching is yet to be defined. For recipients with ILD, size-matching decisions are complicated by concerns regarding the potential impact of pre-LTx pulmonary restriction. We evaluate whether a specific donor-to-recipient size-matching strategy, based on predicted total lung capacity, benefits this patient group.
This retrospective, single-centre, cohort study describes the post-LTx outcomes of adults who underwent LTx for ILD between 1983 and 2020. Only patients with restrictive physiology, based on pre-LTx pulmonary function testing were included. Post-LTx outcomes were compared based on donor-recipient predicted TLC (D-R pTLC) ratio. A D-R pTLC ratio of ≥0.8 or |
| doi_str_mv | 10.1016/j.healun.2021.06.013 |
| format | Article |
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This retrospective, single-centre, cohort study describes the post-LTx outcomes of adults who underwent LTx for ILD between 1983 and 2020. Only patients with restrictive physiology, based on pre-LTx pulmonary function testing were included. Post-LTx outcomes were compared based on donor-recipient predicted TLC (D-R pTLC) ratio. A D-R pTLC ratio of ≥0.8 or <1.2 for DLTx, and a D-R pTLC ratio of ≥0.8 or <1.0 for SLTx were classified as ‘size-matched’.
Five-hundred and fifty LTx recipients met inclusion criteria. Of these, 404 underwent DLTx and 146 underwent SLTx. Size-matching was achieved in 78% of DLTx and 47% of SLTx. Overall survival (p = 0.007) and CLAD-free survival (p < 0.001) was significantly improved following a size-matched DLTx, compared to those with D-R pTLC ratios <0.8 or ≥1.2. Size-matching based on a D-R pTLC ratio 0.8≥ <1.0 for SLTX did not significantly improve survival.
D-R pTLC size-matching, based on a ratio of 0.8≥ <1.2 improved post-DLTx outcomes for patients with restrictive lung disease. This is simple to do, and if applied clinically, could improve overall outcomes in lung transplantation.]]></description><identifier>ISSN: 1053-2498</identifier><identifier>EISSN: 1557-3117</identifier><identifier>DOI: 10.1016/j.healun.2021.06.013</identifier><identifier>PMID: 34301464</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>donor-recipient size matching ; Female ; Follow-Up Studies ; Humans ; interstitial lung disease ; Lung - physiology ; Lung Diseases, Interstitial - physiopathology ; Lung Diseases, Interstitial - surgery ; lung transplantation ; Lung Transplantation - statistics & numerical data ; Male ; Middle Aged ; Organ Size ; Practice Guidelines as Topic ; predicted total lung capacity ; Retrospective Studies ; Tissue Donors ; Total Lung Capacity - physiology ; Transplant Recipients</subject><ispartof>The Journal of heart and lung transplantation, 2021-11, Vol.40 (11), p.1422-1430</ispartof><rights>2021 International Society for Heart and Lung Transplantation</rights><rights>Copyright © 2021 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c362t-3f2459eb9deea73447efdf68f7d34d54374b1793ef959e663b9693a60162dbc33</citedby><cites>FETCH-LOGICAL-c362t-3f2459eb9deea73447efdf68f7d34d54374b1793ef959e663b9693a60162dbc33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1053249821023883$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27903,27904,65309</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34301464$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Riddell, Peter</creatorcontrib><creatorcontrib>Ma, Jin</creatorcontrib><creatorcontrib>Dunne, Ben</creatorcontrib><creatorcontrib>Binnie, Matthew</creatorcontrib><creatorcontrib>Cypel, Marcello</creatorcontrib><creatorcontrib>Donahoe, Laura</creatorcontrib><creatorcontrib>de Perrot, Marc</creatorcontrib><creatorcontrib>Pierre, Andrew</creatorcontrib><creatorcontrib>Waddell, Tom K.</creatorcontrib><creatorcontrib>Yeung, Jonathan</creatorcontrib><creatorcontrib>Yasufuku, Kazuhiro</creatorcontrib><creatorcontrib>Tomlinson, George</creatorcontrib><creatorcontrib>Singer, Lianne G.</creatorcontrib><creatorcontrib>Keshavjee, Shaf</creatorcontrib><title>A simplified strategy for donor-recipient size-matching in lung transplant for interstitial lung disease</title><title>The Journal of heart and lung transplantation</title><addtitle>J Heart Lung Transplant</addtitle><description><![CDATA[Donor-recipient size-matching has been repeatedly reported to improve outcomes following lung transplantation (LTx). However, there is significant variability in practice and the optimal strategy for size-matching is yet to be defined. For recipients with ILD, size-matching decisions are complicated by concerns regarding the potential impact of pre-LTx pulmonary restriction. We evaluate whether a specific donor-to-recipient size-matching strategy, based on predicted total lung capacity, benefits this patient group.
This retrospective, single-centre, cohort study describes the post-LTx outcomes of adults who underwent LTx for ILD between 1983 and 2020. Only patients with restrictive physiology, based on pre-LTx pulmonary function testing were included. Post-LTx outcomes were compared based on donor-recipient predicted TLC (D-R pTLC) ratio. A D-R pTLC ratio of ≥0.8 or <1.2 for DLTx, and a D-R pTLC ratio of ≥0.8 or <1.0 for SLTx were classified as ‘size-matched’.
Five-hundred and fifty LTx recipients met inclusion criteria. Of these, 404 underwent DLTx and 146 underwent SLTx. Size-matching was achieved in 78% of DLTx and 47% of SLTx. Overall survival (p = 0.007) and CLAD-free survival (p < 0.001) was significantly improved following a size-matched DLTx, compared to those with D-R pTLC ratios <0.8 or ≥1.2. Size-matching based on a D-R pTLC ratio 0.8≥ <1.0 for SLTX did not significantly improve survival.
D-R pTLC size-matching, based on a ratio of 0.8≥ <1.2 improved post-DLTx outcomes for patients with restrictive lung disease. This is simple to do, and if applied clinically, could improve overall outcomes in lung transplantation.]]></description><subject>donor-recipient size matching</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>interstitial lung disease</subject><subject>Lung - physiology</subject><subject>Lung Diseases, Interstitial - physiopathology</subject><subject>Lung Diseases, Interstitial - surgery</subject><subject>lung transplantation</subject><subject>Lung Transplantation - statistics & numerical data</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Organ Size</subject><subject>Practice Guidelines as Topic</subject><subject>predicted total lung capacity</subject><subject>Retrospective Studies</subject><subject>Tissue Donors</subject><subject>Total Lung Capacity - physiology</subject><subject>Transplant Recipients</subject><issn>1053-2498</issn><issn>1557-3117</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1r3DAQhkVpaL76D0rxMRc7kkaS40thWdImEMglOQvZGu1q8VclbWDz66PF2xx7Gh2eV-_MQ8gPRitGmbrdVVs0_X6sOOWsoqqiDL6QCyZlXQJj9df8phJKLpq7c3IZ445SykHyb-QcBFAmlLgg21UR_TD33nm0RUzBJNwcCjeFwk7jFMqAnZ89jilz71gOJnVbP24KPxa5fFPkxBjn3mTgGPJjwhCTT970C2B9RBPxmpw500f8fppX5PX3_cv6oXx6_vO4Xj2VHSieSnBcyAbbxiKaGoSo0Vmn7lxtQVgpoBYtqxtA12RMKWgb1YBR2Qi3bQdwRW6Wf-cw_d1jTHrwscM-b4jTPmoupWS0AaAZFQvahSnGgE7PwQ8mHDSj-uhY7_TiWB8da6p0dpxjP08N-3ZA-xn6JzUDvxYA851vHoOOXTbYofXZZtJ28v9v-ABkjZDF</recordid><startdate>202111</startdate><enddate>202111</enddate><creator>Riddell, Peter</creator><creator>Ma, Jin</creator><creator>Dunne, Ben</creator><creator>Binnie, Matthew</creator><creator>Cypel, Marcello</creator><creator>Donahoe, Laura</creator><creator>de Perrot, Marc</creator><creator>Pierre, Andrew</creator><creator>Waddell, Tom K.</creator><creator>Yeung, Jonathan</creator><creator>Yasufuku, Kazuhiro</creator><creator>Tomlinson, George</creator><creator>Singer, Lianne G.</creator><creator>Keshavjee, Shaf</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202111</creationdate><title>A simplified strategy for donor-recipient size-matching in lung transplant for interstitial lung disease</title><author>Riddell, Peter ; Ma, Jin ; Dunne, Ben ; Binnie, Matthew ; Cypel, Marcello ; Donahoe, Laura ; de Perrot, Marc ; Pierre, Andrew ; Waddell, Tom K. ; Yeung, Jonathan ; Yasufuku, Kazuhiro ; Tomlinson, George ; Singer, Lianne G. ; Keshavjee, Shaf</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c362t-3f2459eb9deea73447efdf68f7d34d54374b1793ef959e663b9693a60162dbc33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>donor-recipient size matching</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>interstitial lung disease</topic><topic>Lung - physiology</topic><topic>Lung Diseases, Interstitial - physiopathology</topic><topic>Lung Diseases, Interstitial - surgery</topic><topic>lung transplantation</topic><topic>Lung Transplantation - statistics & numerical data</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Organ Size</topic><topic>Practice Guidelines as Topic</topic><topic>predicted total lung capacity</topic><topic>Retrospective Studies</topic><topic>Tissue Donors</topic><topic>Total Lung Capacity - physiology</topic><topic>Transplant Recipients</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Riddell, Peter</creatorcontrib><creatorcontrib>Ma, Jin</creatorcontrib><creatorcontrib>Dunne, Ben</creatorcontrib><creatorcontrib>Binnie, Matthew</creatorcontrib><creatorcontrib>Cypel, Marcello</creatorcontrib><creatorcontrib>Donahoe, Laura</creatorcontrib><creatorcontrib>de Perrot, Marc</creatorcontrib><creatorcontrib>Pierre, Andrew</creatorcontrib><creatorcontrib>Waddell, Tom K.</creatorcontrib><creatorcontrib>Yeung, Jonathan</creatorcontrib><creatorcontrib>Yasufuku, Kazuhiro</creatorcontrib><creatorcontrib>Tomlinson, George</creatorcontrib><creatorcontrib>Singer, Lianne G.</creatorcontrib><creatorcontrib>Keshavjee, Shaf</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of heart and lung transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Riddell, Peter</au><au>Ma, Jin</au><au>Dunne, Ben</au><au>Binnie, Matthew</au><au>Cypel, Marcello</au><au>Donahoe, Laura</au><au>de Perrot, Marc</au><au>Pierre, Andrew</au><au>Waddell, Tom K.</au><au>Yeung, Jonathan</au><au>Yasufuku, Kazuhiro</au><au>Tomlinson, George</au><au>Singer, Lianne G.</au><au>Keshavjee, Shaf</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A simplified strategy for donor-recipient size-matching in lung transplant for interstitial lung disease</atitle><jtitle>The Journal of heart and lung transplantation</jtitle><addtitle>J Heart Lung Transplant</addtitle><date>2021-11</date><risdate>2021</risdate><volume>40</volume><issue>11</issue><spage>1422</spage><epage>1430</epage><pages>1422-1430</pages><issn>1053-2498</issn><eissn>1557-3117</eissn><abstract><![CDATA[Donor-recipient size-matching has been repeatedly reported to improve outcomes following lung transplantation (LTx). However, there is significant variability in practice and the optimal strategy for size-matching is yet to be defined. For recipients with ILD, size-matching decisions are complicated by concerns regarding the potential impact of pre-LTx pulmonary restriction. We evaluate whether a specific donor-to-recipient size-matching strategy, based on predicted total lung capacity, benefits this patient group.
This retrospective, single-centre, cohort study describes the post-LTx outcomes of adults who underwent LTx for ILD between 1983 and 2020. Only patients with restrictive physiology, based on pre-LTx pulmonary function testing were included. Post-LTx outcomes were compared based on donor-recipient predicted TLC (D-R pTLC) ratio. A D-R pTLC ratio of ≥0.8 or <1.2 for DLTx, and a D-R pTLC ratio of ≥0.8 or <1.0 for SLTx were classified as ‘size-matched’.
Five-hundred and fifty LTx recipients met inclusion criteria. Of these, 404 underwent DLTx and 146 underwent SLTx. Size-matching was achieved in 78% of DLTx and 47% of SLTx. Overall survival (p = 0.007) and CLAD-free survival (p < 0.001) was significantly improved following a size-matched DLTx, compared to those with D-R pTLC ratios <0.8 or ≥1.2. Size-matching based on a D-R pTLC ratio 0.8≥ <1.0 for SLTX did not significantly improve survival.
D-R pTLC size-matching, based on a ratio of 0.8≥ <1.2 improved post-DLTx outcomes for patients with restrictive lung disease. This is simple to do, and if applied clinically, could improve overall outcomes in lung transplantation.]]></abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>34301464</pmid><doi>10.1016/j.healun.2021.06.013</doi><tpages>9</tpages></addata></record> |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | donor-recipient size matching Female Follow-Up Studies Humans interstitial lung disease Lung - physiology Lung Diseases, Interstitial - physiopathology Lung Diseases, Interstitial - surgery lung transplantation Lung Transplantation - statistics & numerical data Male Middle Aged Organ Size Practice Guidelines as Topic predicted total lung capacity Retrospective Studies Tissue Donors Total Lung Capacity - physiology Transplant Recipients |
| title | A simplified strategy for donor-recipient size-matching in lung transplant for interstitial lung disease |
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